Surgery of left ventricular aneurysm: a propensity score-matched study of outcomes following different repair techniques

Abstract

To evaluate early and late outcomes of modified left ventricular reconstruction (VR) and linear repair (LR) of post-infarct left ventricular aneurysm (LVA). A total of 514 patients were consecutively operated on for LVA with modified VR technique in 145 and LR in 352 patients. Using the propensity score-matching method, we selected 202 patients (101 LRs vs. 101 VRs) with similar pre- and intra-operative characteristics and compared their clinical outcomes. After matching, the two groups of patients were similar with regard to baseline data. The increment of left ventricular ejection fraction (LVEF) in VR group was more significant than that in LR group. Operative mortality was 2.0% (2.0% LRs vs. 2.0% VRs, P=NS). There was a statistically significant difference between LR and VR patients in MACCEs (29.7% LRs vs. 13.9% VRs, P<0.01) and hospital readmissions (51.5% LRs vs. 30.7% VRs, P<0.01). Overall long-term mortality and cardiac mortality were the same between the two groups (mortality: 11.9% LRs vs. 11.9% VRs, P=NS; cardiac mortality: 9.9% LRs vs. 7.9% VRs, P=NS). The technique of repairing LVA did not affect the early and later mortality.